When a toddler tested positive for a sexually transmitted disease at a Nassau hospital recently, state law required physicians to report their suspicions of abuse immediately to the state's child abuse hotline, according to local child advocates familiar with the case. Instead, it took doctors several days to report the case, despite a 2007 law mandating prompt action when professionals, including...

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When a toddler tested positive for a sexually transmitted disease at a Nassau hospital recently, state law required physicians to report their suspicions of abuse immediately to the state's child abuse hotline, according to local child advocates familiar with the case.

Instead, it took doctors several days to report the case, despite a 2007 law mandating prompt action when professionals, including doctors or teachers, suspect abuse.

Local advocates say the incident is one of several examples of state "mandated reporters" -- more than 40 professions required by state law to report abuse allegations -- sending children back to abusive homes out of fear of getting involved, or believing they must investigate an allegation before reporting it to authorities.

With April marking National Child Abuse Prevention Month, advocacy groups including the Bethpage-based Coalition Against Child Abuse & Neglect and the Education & Assistance Corp.'s Suffolk County Child Advocacy Center in Central Islip are ramping up outreach efforts at schools, libraries and hospitals to educate professionals and the public about the state's reporting law.

"People professionally or personally have a blind streak," said Anthony Zenkus, director of education for the Coalition Against Child Abuse and Neglect, a nonprofit that provides counseling services to abuse victims. "They feel they have to know for sure that it's really abuse before deciding to report. It's when people say to themselves 'I'm not sure,' that the case doesn't get called in, subjecting that child to more years of abuse."

In 2007, state lawmakers passed "Xctasy's Law" -- named after a 4-year old Schenectady girl whose severe abuse went unreported for years -- to expand the criteria for filing an abuse report with the state.

Previously, a call to the state's abuse hotline was required only if a mandated reporter observed signs of abuse firsthand or learned about it directly from the child, a parent or guardian.

Under the 2007 law, a call also must be made if the reporter learns of suspected abuse from third-hand sources, including classmates and friends who can provide accounts "sufficient to give the [state] social services worker a reasonable cause to suspect child abuse."

"With this reform today, we will help ensure that every case of suspected child abuse and neglect is fully investigated and dealt with appropriately," then-Gov. Eliot Spitzer said when he signed the bill.But Zenkus said the coalition continues to learn of mishandled cases. They include a therapist who for months did not report a child's claims of sexual abuse, which escalated to more severe levels of abuse, and school administrators who after questioning a child still sent her home that day to a potentially harmful situation.

"People need to understand in reality it's not up to us to determine whether the allegations are false or not," said Andrea Ramos-Topper, executive director of the EAC Suffolk Child Advocacy Center, a nonprofit that provides counseling services to sexual abuse victims. "That's really the role of CPS and the investigative agencies."

Once a call is made to the state's hotline, county child protective investigators must launch an investigation within 24 hours. Last year, Nassau handled 6,344 reports of suspected child abuse and Suffolk handled 9,692, according to state figures. On average, one-third of those reports become cases of substantiated abuse requiring further action by child protective officials, Zenkus said.

Mandated reporters who do not report suspected abuse could face a Class A misdemeanor charge punishable by up to a year in jail and a maximum $1,000 fine. State Office of Children and Family Officials say they do not keep data on the number of people who have violated the law.

"More important than the penalty is the awareness," Ramos-Topper said. "It's crucial for mandated reporters to follow up on their responsibilities."

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